Medical Debt, Organizing Reunions, and Restorations

Pittsburgh The Pittsburgh ACORN Family Reunion Picnic organized by ANEW Institute in Homestead was battling bad weather forecasts and real raindrops that moved the affair from the park to the porch of the Baker House on 11th. The score of folks who came by couldn’t have cared less, because they got to see the progress on the renovation of the building which will be their future office, and even more so they wanted to talk. About issues. About education. About health. About the community. About ACORN. About building organization again in all the smaller communities on the Southside and what they called the Mon Valley after the great Monongahela River, one of the three rivers defining Pittsburgh and western Pennsylvania.

One of the picnickers had worked for the giant University of Pittsburgh Medical Center, now universally in this area as UPMC with a skyscraper highlighting their letters looming over the cityscape. UPMC is reckoned as the largest hospital system in the country. One thing led to another though and the more we talked about hospitals, healthcare, and citizen wealth, the more impossible it was to not talk about medical debt. A quick poll of the celebrants of ACORN’s 45th birthday found that one-third were carrying medical debt now and still facing persistent health problems. It was also clear that all of folks raising their hands qualified for charity care and all of them were caught in the gears of the giant UPMC system.

Later when we took a quick look at the UPMC numbers it was unsettling to say the least. 38 hospitals with almost 60,000 workers and over $10 billion dollars in program service revenue, yet the amount of charity care they provided was hardly better than 1% when the national average for nonprofits is over 6%. There were horror stories of “point of service” collection tactics where patients, even those on Medicare, were being asked to pay down payments and deductibles before being admitted or treated in the emergency room at least until an advocate joined them and forcibly raised the issue of charity care.

Maybe UPMC doesn’t get it or thinks they can get away with it, because this is just the standard operating procedure in the Pittsburgh area. One woman told a moving and tragic story about being “naïve,” which must be a euphemism for having been robbed. She had bought a house using the always sketchy rent-to-own system and the landlord-owner tried to sell the property after she had sunk $30000 in improvements into the house. There was nothing but home cooking in this tale where politicians and others ganged up on her family in the thievery. The court ended up agreeing with her that she was robbed but she still didn’t recover either the money or the house because of various technicalities. The trigger for the story had been her testimony for how much ACORN had meant to her and the fact that they stood with her in the fight and were clear this was predatory and a crime.

The chicken was good and the beans were great, but people left talking about how, just as ACORN had done in the past, they needed to organize their communities again and build ACORN in the future. What a great way reunion and a great way to celebrate a birthday!